The introduction of structural adjustment program (SAP) in Uganda in 1981 coincided with the launch of a guerrilla war by the military wing of the National Resistance Movement (NRM) against an elected government of Uganda. Political economy analysts in the NRM carefully studied the impact of SAP conditionality in Uganda and Ghana. They concluded that the SAP model sponsored by the IMF and the World Bank was not suitable for Uganda. They drew up an alternative political economy model of a mixed economy based on private and public partnership. The model was published in 1985 as a ten-point program. It was a consensus blue print that was carefully prepared by Ugandans in consultation with a wide range of stakeholders. Thus, it was a home grown program.
When NRM captured power in 1986, the ten-point program became the national development policy platform. To avoid conditionality associated with IMF and World Bank assistance, the government bypassed the two institutions in mobilizing funds to implement the program. However, western bilateral donors would not extend a helping hand unless agreement with the World Bank and IMF had been agreed upon. Ultimately the government caved in and signed an agreement with the IMF in 1987 with all the conditionality. The ten point program was abandoned. Many Ugandans were very unhappy about the decision and criticized the shock therapy approach to structural adjustment program that was adopted. The introduction of SAP was followed by an internal struggle between those who wanted a gradual and sequenced approach (gradualists) to mitigate the social impact on the one hand and those who wanted a rapid and simultaneous implementation (shock therapists) of all SAP elements favored by the World Bank and IMF on the other hand. The government waited until the voices of the opposition were silenced. It then organized a national conference of December 1989 which gave the government the green light to launch a full-scale structural adjustment program based on market forces and private sector as the engine of economic growth. The remaining gradualists were dismissed or marginalized. With opposition out of the way, the shock therapists in the ministry of finance and central bank were given full powers to implement a neo-liberal program backstopped by foreign experts under the supervision of World Bank and IMF officials. The focus was placed on economic growth, inflation control, accumulation of foreign currency through increased and diversified exports of raw materials and domestic demand compression, privatization of public enterprises and liberalization of Uganda’s economy that permitted imports of goods and services that undermined domestic enterprises. The social sectors considered unproductive were placed on the back burner waiting to benefit from a trickle down mechanism which never occurred.
As implementation progressed, the shortcomings of SAP began to be felt, raising voices of dissent. The government would not tolerate criticism and those who insisted on being heard were dubbed saboteurs bent on undermining the work of the government to eradicate poverty and create a middle class economy and society. With opposition out of the way, the market forces and private sector took charge of Uganda’s economy. Income distribution favored the rich. Social and environmental sectors were denied adequate funds resulting in unemployment, diseases of poverty and environmental degradation. Growth in GDP and per capita incomes were no longer sufficient to justify continued implementation of structural adjustment program which was finally abandoned in 2009.
In retrospect, it is believed that if the opposition voices had been heard and taken into consideration by government, an appropriate combination of private and public policies would have been introduced to address the imperfections of structural adjustment. This lesson needs to be taken into consideration as Uganda embarks on another major policy decision about to be taken. This is family planning or birth control.
The NRM government does not have a birth control program because of strong feelings that Uganda‘s population has not yet reached an optimal size in relation to its endowments. However, like in the case of structural adjustment, external pressure in favor of birth control is building up very fast. One of the reasons why birth control began in the 1960s failed to produce expected results in Africa is that it was directed by foreigners immediately after attaining independence. Africans interpreted active external involvement as a hidden strategy to weaken African countries and re-colonize the continent.
A new approach has thus been developed. The advocacy for birth control in Uganda is now being driven by Ugandans from different sectors. Seminars are being conducted and articles written by Ugandans – journalists, economists, lawyers and Members of Parliament etc – most of them if not all without demographic expertise and experience. All these efforts have converged virtually on fertility control through contraception. This approach has the following shortcomings and if not addressed will cause birth control to fail like SAP did.
First, Ugandans with different views about birth control are by and large being shut out. The articles they have prepared are not being published in major local newspapers.
Second, population growth in a particular country is the result of natural population growth (births over deaths) and excess of in-migrants over out-migrants. Uganda has since the 1920s been a recipient of in-migrants far in excess of out-migrants. People come to Uganda for economic and political reasons and most are allowed to stay. At the time of independence in 1962, forty percent of Buganda’s population was made up of Banyarwanda who entered Uganda for economic and political reasons and stayed. If you add on migrants from Kenya, Sudan and DRC who worked in Buganda before independence you may find that indigenous Baganda were less than fifty percent at independence. Since independence many more in-migrants have entered Uganda than have gone out with a large number residing in Buganda because of its big towns including the capital city and rural economic activities. Uganda has since 1986 received Eritreans, Ethiopians, Kenyans, Sudanese, Congolese and Somalis. Therefore, authorities and those interested in Uganda’s population growth must take the migration factor into account. So far, there has been total silence on this demographic dimension!
Third, those that have written about high fertility rate are shy about the causes and geographic or social areas of concentration. They are afraid to mention poverty and hunger which induce people to have many children as this would contradict government position that poverty has been reduced significantly. They are afraid to mention school drop-out and subsequent early marriage because this would contradict government policy of universal primary education. They are afraid to write that women are not empowered and therefore not able to control their reproduction because this would contradict government position that women have been empowered witness Members of Parliament and cabinet ministers.
Fourth, in the absence of vital registration of births and deaths and migration, the writers about high population growth are groping in the dark, using population forecasts from external sources that are highly unreliable.
Like in the case of structural adjustment, the government which cannot resist external pressure behind birth control is neutral about the proliferation of articles from supporters of birth control as they struggle to build a critical mass. The government will then likely organize a national conference of these supporters and declare that there is consensus about the dangers of rapid population growth through high fertility rates and may impose birth control and set a limit on the number of children a couple can legally produce. Opponents will be accused of sabotage and then silenced.
Given the history and politics of Uganda, imposing or legalizing birth control will be very difficult to implement. Reducing population by fiat is not as easy as increasing the price of beans. The poor people will not do it, the rich people will not do it, the Protestants will not do it, the Catholics will not do it, the Muslims will not do it, the northerners will not do it, and the southerners will not do it. Focusing on a particular group or region will raise the thorny issues of genocide.
The only short-term solution is to have side effects-free family planning facilities for those who volunteer to control births. In the long-term the controversial-free solution is to educate girls to secondary level and above and genuinely empower women economically and politically so that they can manage their reproduction without obtaining permission first from their spouses, involve men in the exercise and above all end poverty and hunger and Ugandans will make informed decisions on their own about the number of children they need and how to space them. Short of this, Uganda will end up abandoning birth control (after many years of wasted resources) as official policy as it has abandoned structural adjustment program (after over 20 years of wasted resources). Constructive opposition voices should not be ignored.